Healthcare Provider Details

I. General information

NPI: 1073436671
Provider Name (Legal Business Name): SARAH JACOBS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 SCOTTS LN STE 405
PHILADELPHIA PA
19129-1697
US

IV. Provider business mailing address

1500 LOCUST ST APT 1518
PHILADELPHIA PA
19102-4315
US

V. Phone/Fax

Practice location:
  • Phone: 602-499-5585
  • Fax:
Mailing address:
  • Phone: 602-499-5585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOC021626
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: